Bruce H Wellmon DPM PA

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

86 Issued in SC

Legal business name

BRUCE H WELLMON DPM PA

Practice address

101 Professional Park
Gaffney, SC 29340

Phone

(864) 487-5516

Fax

(864) 487-3477

NPI assigned

Aug 29, 2007

Last updated

Aug 29, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bruce H Wellmon, DPMNPI 1437346475

Title

DPM

Phone

(864) 487-5516

Specialties & licenses 4

Addresses

Other identifiers 3

Electronic endpoints 1

Tax ID family

Bruce H Wellmon DPM2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bruce H Wellmon DPM PA

  • Podiatrist
  • Gaffney, SC
  • NPI 1780677682
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce H Wellmon, DPM

  • Podiatrist
  • Gaffney, SC
  • NPI 1437346475
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1821282146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1436",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293421436",
            "telephone_number": "864-487-5516",
            "fax_number": "864-487-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL PARK",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "29340",
            "telephone_number": "864-487-5516",
            "fax_number": "864-487-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE H WELLMON DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "WELLMON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "864-487-5516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "86",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "86",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "216",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "1738",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908156",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD0868",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "DM0706",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drbrucewellmon@bellsouth.net",
            "affiliation": "N",
            "address_1": "101 Professional Park",
            "city": "Gaffney",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Bruce H Wellmon DPM PA
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• Durable Medical Equipment & Medical Supplies in Gaffney, SC
• Providers in Gaffney, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.